Effectiveness of a Community-Based Physical Activity and Nutrition Behavior Intervention on Features of the Metabolic Syndrome: A Cluster-Randomized Controlled Trial

2017 ◽  
Vol 15 (2) ◽  
pp. 63-71 ◽  
Author(s):  
Van Dinh Tran ◽  
Anthony P. James ◽  
Andy H. Lee ◽  
Jonine Jancey ◽  
Peter A. Howat ◽  
...  
Keyword(s):  
Physical Activity ◽  
Metabolic Syndrome ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Behavior Intervention ◽  
Community Based ◽  
Randomized Controlled ◽  
The Metabolic Syndrome ◽  
Nutrition Behavior ◽  
Cluster Randomized

Abstract 070: Community-based, Cluster Randomized Controlled Trial Increases Physical Activity In Diverse, Low Income Older Adults Over 2-year Period

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Katie Crist ◽  
Fatima Tuz Zahra ◽  
Kelsie M Full ◽  
Marta M Jankowska ◽  
Loki Natarajan
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Randomized Controlled Trial ◽  
Depressive Symptoms ◽  
Low Income ◽  
Controlled Trial ◽  
Community Based ◽  
Randomized Controlled ◽  
Income Status ◽  
Cluster Randomized

Objective: Older adults are the least active population group in the U.S. Low income and ethnically diverse communities have fewer physical activity (PA) related resources and facilities, which contributes to lower PA levels and disparities in cardiovascular (CVD) risk factors and disease outcomes. This study assessed the hypothesis that low income and diverse older adults participating in the multilevel Peer Empowerment Program 4 Physical Activity (PEP4PA) would increase moderate-to-vigorous PA (MVPA), improve blood pressure (BP), perceived quality of life (PQoL), and depressive symptoms to a greater extent than older adults receiving usual senior center programming. Methods: In a cluster-randomized controlled trial (RCT) in 12 senior centers, 476 older adults (mean age 71.4 years, 76% female, 60% low income, 38% minority) were assigned to a PA intervention (n=267) or control (n=209) condition. The peer-led intervention included individual self-monitoring and counseling, group walks and social support, and community advocacy to improve walking conditions. Outcomes included minutes of MVPA per day (7-day accelerometer), systolic and diastolic BP (automatic cuff), PQoL (PQoL-20) and depressive symptoms (CES-D 10) at baseline, 6, 12, 18 and 24 months. To account for multiple measurement days and clustering of participants within senior centers, mixed effects regression models with random effects estimated the intervention effects on all outcomes between groups over time. Models were adjusted for imbalanced baseline covariates. A three-way interaction term assessed whether intervention effects differed by income status. Results: Compared to the control group, intervention participants significantly increased MVPA from baseline at 6, 12, 18 and 24 months by 8, 11, 9 and 9 minutes/day respectively (p<0.001), with increases remaining statistically significant across the 2-year period. The intervention group significantly increased mean PQoL scores from 7.2 at baseline to 7.6 (p<0.001), 7.8 (p=0.008) and 7.7 (p<0.001) at 12, 18 and 24 months, compared to control participants. No significant effects were observed for BP or depressive symptoms. Low income participants decreased minutes of MVPA, compared to higher income participants, at 12 and 24 months (β=-7.9, p=0.008 and β=-10.8, p=0.001). Conclusions: The multilevel RCT achieved sustained increases in MVPA and QoL in a diverse cohort of older adults across 2 years of follow up. The peer-led, community-based intervention provides a sustainable model to improve health behaviors related to CVD in an at-risk and often difficult to reach aging population. Further exploration is needed to understand what components of the intervention may be modified to address the differential effects by income status.

scholarly journals A Three-Month Consumption of Eggs Enriched with ω-3, ω-5 and ω-7 Polyunsaturated Fatty Acids Significantly Decreases the Waist Circumference of Subjects at Risk of Developing Metabolic Syndrome: A Double-Blind Randomized Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 663
Author(s):  
Monique T. Ngo Njembe ◽  
Barbara Pachikian ◽  
Irina Lobysheva ◽  
Nancy Van Overstraeten ◽  
Louis Dejonghe ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
At Risk ◽  
Randomized Controlled Trial ◽  
Waist Circumference ◽  
Controlled Trial ◽  
Density Lipoprotein ◽  
Test Group ◽  
Double Blind ◽  
Randomized Controlled ◽  
The Metabolic Syndrome

Alpha-linolenic acid (ALA), docosahexaenoic acid (DHA), rumenic acid (RmA), and punicic acid (PunA) are claimed to influence several physiological functions including insulin sensitivity, lipid metabolism and inflammatory processes. In this double-blind randomized controlled trial, we investigated the combined effect of ALA, DHA, RmA and PunA on subjects at risk of developing metabolic syndrome. Twenty-four women and men were randomly assigned to two groups. Each day, they consumed two eggs enriched with oleic acid (control group) or enriched with ALA, DHA, RmA, and PunA (test group) for 3 months. The waist circumference decreased significantly (−3.17 cm; p < 0.001) in the test group. There were no major changes in plasma insulin and blood glucose in the two groups. The dietary treatments had no significant effect on endothelial function as measured by peripheral arterial tonometry, although erythrocyte nitrosylated hemoglobin concentrations tended to decrease. The high consumption of eggs induced significant elevations in plasma low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol (p < 0.001), which did not result in any change in the LDL/HDL ratio in both groups. These results indicate that consumption of eggs enriched with ALA, DHA, RmA and PunA resulted in favorable changes in abdominal obesity without affecting other factors of the metabolic syndrome.

scholarly journals Community-Based Cluster Randomized Controlled Trial: Empowering Households to Identify and Provide Appropriate Care for Low-Birthweight Newborns in Nepal

2020 ◽  
Author(s):  
Stephen Hodgins ◽  
Binamra Rajbhandari ◽  
Deepak Joshi ◽  
Bharat Ban ◽  
Subarna Khatry ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Low Birthweight ◽  
Controlled Trial ◽  
Care Seeking ◽  
Apparent Effect ◽  
Community Based ◽  
Randomized Controlled ◽  
Appropriate Care ◽  
Cluster Randomized ◽  
Skin To Skin

Abstract Background: Most newborn deaths occur among those of low birthweight (LBWt), due to prematurity &/or impaired fetal growth. Simple practices can mitigate this risk. In low-income country settings where many births occur at home, strategies are needed that empower mothers to determine if their babies are higher risk and take protective measures. Earlier studies suggest that foot-length may be a good proxy for birthweight. An earlier Nepal study found a 6.9cm cut-off performed relatively well, differentiating normal from low birthweight.Methods: Community-based, cluster-randomized controlled trial. Objective: to determine whether family-administered screening, with targeted messages improves care practices known to mitigate LBWt risks. Participants: pregnant women participating in a parent trial in rural Nepal. Women were given a 6.9cm card to assess whether the baby’s foot is small; if so, to call number on the card for advice. Follow-up visits were made over 2 weeks following the birth, assessing for: reported skin-to-skin thermal care, and care-seeking outside the home; restricting to low birthweight (using 2 cutoffs: 2,500g and 2,000g). Randomization: 17 clusters intervention, 17 control. The study also documented steps along the presumed causal chain from intervention through behavioral impact.Results: 2,022 into intervention, 2,432 into control. Intervention arm: 519 with birthweight <2,500g (vs. 663 among controls), of which 503 were available for analysis (vs. 649 among controls). No significant difference on care-seeking; for those <2,500g RR 1.13 (95%CI: 0.97-1.131). More of those in the intervention arm reported skin-to-skin thermal care than among controls; for those <2,500g RR 2.50 (95%CI: 2.01-3.1). Process measures suggest this apparent effect cannot be attributed to the intervention; the card performed poorly as a proxy for LBWt, misclassifying 84.5% of those <2,000 as normal.Conclusions: Although the trial found an apparent effect on one key behavioral outcome, this cannot be attributed to the intervention; most likely it was a result of pure chance. Other approaches are needed for identifying at-risk babies in such settings, and targeting them for appropriate care messaging.Trial registration : clinicaltrials.gov identifier: NCT02802332, registered 16 June 2016, https://clinicaltrials.gov/ct2/show/NCT02802332

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